| NPI | 1619966058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01068276A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101261638) |
| 207Q00000X Family Medicine (Licence: MI 4301104697) | |
| 207Q00000X Family Medicine (Licence: RI MD16478) | |
| 207Q00000X Family Medicine (Licence: CA C159538) | |
| 207Q00000X Family Medicine (Licence: AR E-11879) | |
| 207Q00000X Family Medicine (Licence: GA 081939) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2023-09-11 |